title: Evaluation of iNtRON VRE vanA/vanB real-time PCR for follow-up surveillance of VRE-infected or colonized patients.
abstract: The iNtRON vancomycin-resistant enterococci (VRE) vanA/vanB real-time PCR assay was directly applied to stool surveillance (direct-PCR). direct-PCR was compared to 2 culture-based methods using Enterococcosel broth (enrichment-culture) and ChromID VRE media. The positive broth of the enrichment-culture was submitted to phenotypic confirmation of subcultured colonies and genotyping by Seeplex VRE PCR. From September 2011 to May 2012, 208 stool specimens from 188 patients previously positive for VRE were enrolled. Enrichment-culture and direct-PCR detected 178 and 158 positives, respectively. Among 129 specimens cultured with ChromID, direct-PCR and ChromID yielded 105 and 104 positives, respectively. Compared to the enrichment-culture, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of direct-PCR and ChromID were 86.0%, 83.3%, 96.8%, 50.0%, and 89.5%, 86.7%, 98.1%, 52.0%, respectively. Considering the excellent PPV and low NPV, direct-PCR would be useful to monitor VRE-colonized or infected patients on the day, but enrichment-culture is required for direct-PCR-negative specimens.
authors.affiliation: Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea.
authors.forename: Mi Hyun
authors.initials: MH
authors.lastname: Bae
authors.forename: Jaewook
authors.initials: J
authors.lastname: Kim
authors.forename: Heungsup
authors.initials: H
authors.lastname: Sung
authors.forename: Yun Sil
authors.initials: YS
authors.lastname: Jeong
authors.forename: Mi-Na
authors.initials: MN
authors.lastname: Kim
mesh_terms: D015373:Bacterial Typing Techniques / Q000379:methods; D016983:Enterococcus / Q000187:drug effects* / Q000235:genetics*; D005798:Genes, Bacterial; D005838:Genotype; D016908:Gram-Positive Bacterial Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D011159:Population Surveillance; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012680:Sensitivity and Specificity; D020713:Vancomycin Resistance / Q000235:genetics*
keywords: Enrichment culture; Real-time PCR; Surveillance; Vancomycin-resistant enterococci